The Overconcentration of Care Services for Older People in the Bulgarian Town Dryanovo
The Bulgarian town of Dryanovo has an impressive range of care settings and services for older adults – mainly thanks to EU funding. But will this policy have sustainable or rather short-term results?
Dryanovo is a picturesque small town in Bulgaria, located at the foot of the Balkan Mountains, with a population of 5,800 (2021). Along with its beautiful mountain hills and river gorges, it has an impressive cultural and historical past and archaeological heritage (evidence of human presence from the Paleolithic era, remains of fortresses from Roman times, remains of palaces of medieval Bulgarian rulers, etc.).
Among other things, the town is the administrative centre of the municipality of Dryanovo, which makes it a ground for organising and holding various political and cultural initiatives and events, as well as for coordinating and managing social and community services. By law and tradition, municipalities are responsible for providing all types of social services in Bulgaria. And it is with the construction and maintenance of a wide and comprehensive network of these services, especially for older people, that the development of Dryanovo has been remarkable during the last decades. Thus, a home for older people with dementia, a day care centre for older people, a hospice, a home patronage and three pensioners’ clubs operate in the town. Among the Bulgarian beneficiary municipalities of the Human Resources Development operational programme of the European Union and the European Social Fund, Dryanovo is the municipality that implemented the project with the largest number of services, integrated in the so-called Complex for Social Services for the Elderly[1], worth BGN 2,162,000 (Euro 1.1 million). For comparison, under the same programme the municipality of Lukovit, which is twice as large in population as Dryanovo, has absorbed BGN 50,950 (to provide a passenger car for the needs of the Home Social Patronage) and the four times larger municipality of Samokov has absorbed BGN 368,000 (to provide social services to at least 60 older and disabled people).
How can we explain this concentration of care settings and care services for older people in Dryanovo? To what extent is it a result of sustainable development or is it the municipality’s “short-term asset” for using European funds and programmes? Is Dryanovo a leading example of good care practices or an example to debate specific applications of EU social policies towards ageing?
New possibilities thanks to EU funds
The Dryanovo case can be discussed on different scales and in different temporal perspectives. If we trust the municipality’s website, the cluster of care services looks like one of the achievements of local government in the context of increased consideration of the care for older people as a key priority of the EU. In the last decade, the Bulgarian government adopted strategic documents for improving social and community services in the country such as the National Concept on Promoting Active Ageing in Bulgaria (2012-2030) and the National Strategy for Long-Term Care (2014). The latter, together with a series of changes in the social legislation and with the increasing number of opportunities for receiving financial support from the EU, placed many Bulgarian municipalities as the main providers of local social services in the challenging situation of promoting new types of care settings and building new facilities as well as enhancing and redesigning established ones. Therefore, it is more than expected that the reports of the mayors of Dryanovo for the last years explicitly highlight their successful efforts to improve the quality of existing social services. From their markedly positive discourse, we can conclude what are the requirements for improvement: active cooperation with NGOs and officials from state structures such as the Social Assistance Directorate, readiness to launch new services and dealing with European programmes. A particular example in this respect is the home patronage in the town. If in the large districts of the capital in Sofia, the users of the service receive only a hot meal per day, in Dryanovo – at least according to what is written on the website – 62 users can rely on being helped to buy products and being helped to pay household bills or to make an appointment with a doctor.
The various municipal initiatives taking place in the town, again addressed to older people, are also exceptional. Thus, in 2016–2017, a “hot lunch” was offered to “people living alone with minimal pensions.” In 2018, a choro dancing was organised for the residents of the home for older people with dementia on the initiative of the manager of the home. In 2019, Dryanovo is one of five towns in the country where people over the age of 55 are being taught how to use computers and smart phones under a programme funded by one of the major national mobile operators.
Socialist legacies meet EU politics
While it may seem like a particular attainment of local authorities, the cluster of care-settings in Dryanovo has a long and curious history. Thus, a home for older people with dementia has existed since the 1960s in a village in the vicinity of the town and was relocated to the town in 1999. This is an unmissable socialist legacy, insofar as between the 1950s and the 1980s, homes for older adults (whether with dementia or not) numbered around 40 for the whole country. They were closed institutions, built in remote locations and with an extremely restrictive daily routine. Exactly what transformations the home has undergone after the relocation deserves special study. However, the relocation of the home from village to town fits into a process of deinstitutionalisation and reformation of care settings, which started after 1989 with democratisation. Accession to the EU (2007), which promotes an open society and supports vulnerable individuals and groups, further enhanced this transformation. It can be assumed that like in most cases of care centres inherited from the socialist period, the staff has remained almost the same. Yet, the daily routine of the residents has changed in line with the agenda of deinstitutionalisation and the respective course towards overcoming the social isolation of older and disabled persons. Currently, the home has a capacity of 52 places. The residents, in addition to receiving health care, are being involved in educational, cultural, and sporting initiatives. Even in Sofia, the home in Dryanovo has a reputation as one of the few good and reliable places to house people living with dementia. However, despite this good reputation, in 2020, 20 residents died during the COVID-19 pandemic. This fact evokes images of past socialist homes that are still remembered and referred to by the older generations in Bulgaria as “prisons” for “living corpses.”
The day care centre for older people in Dryanovo has a complicated fate as well. Unlike the home, it is entirely a “product” of the so-called democratic transition and the promotion of the open society model. One of the first in the country and a pilot community service, it was opened in 2005 on the initiative of the Society for Social Assistance in Dryanovo, which still exists. As the Society’s website points out, it was founded in 1996 by “retired, unemployed, disabled, and single parents.” The biographical trajectories of some of them suggest that they had social and organisational experience, accumulated before 1989 and have been intensively involved in developing the NGO sector since the early 1990s. The establishment of the society was initiated by Professor Evgenia Spasova, Deputy Minister of Labour and Social Policy in the government of prime minister Zhan Videnov (1995–1997) from the Bulgarian Socialist Party, the successor of the Bulgarian Communist Party. Videnov was known as an opponent of the free-market model and a supporter of “socially oriented economic policy.” The “pensioners” mentioned as co-founders of the association were representatives of the local pensioners’ clubs, which are also a legacy of the socialist period. The network of such clubs was built up in the 1960s, and they are still functioning today, often seen as an arena of nostalgia for the communist party-state control over the late-life trajectories.
Thus, the symbiosis of socialist expertise in the social sphere and aspiration for active European-type citizenship clearly worked well in Dryanovo. In the early years of their existence, the Society and the Centre were popularised as an example of providing better quality care for disadvantaged people. The project for a social services complex at the municipality mentioned above was prepared and implemented by the Society. Against this background, it is somewhat puzzling that in 2019 the City Council took a decision to transform the Centre into a Centre for Social Rehabilitation and Integration, which was confirmed in 2020.This kind of social service in Bulgaria developed in recent years as addressing the needs of support and social inclusion of children and adults with disabilities and addicted persons. Hence the Council’s decision more or less corresponded to the main goals and target groups of the Society, however it attempted to change the profile of the Centre, which was recognised as one of the emblematic sites and “trademarks” of the local community. This decision has not yet come into force, however.
As far as the official minutes of the Council meeting at which the decision was taken did not set out any arguments or opinions in this regard, one can only speculate whether it was motivated by the municipality’s orientation towards larger European programmes and funds focused on people with disabilities instead of seniors. The 2018 protests of the mothers of disabled children, which led to the adoption of several laws in favour of disability rights in 2019, give grounds for such an assumption as far as they turned the care for disabled people in key priority of national social policy at least for these two years.
In October 2020, the Centre faced another challenge. Similarly to most of the care homes and day care centres for older people it gained negative visibility during the COVID-19 pandemic. One of Bulgaria’s largest daily newspapers, 24 Chasa, reported that out of a total of 21 staff and centre users examined for the virus, 15 tested positive. Expectedly, the latter encounter serious restrictions on their daily activities and care practices.
Conclusion
The presented history of care settings and services in Dryanovo reveals an overlap between socialist and post-socialist legacies. But this does not fully explain the mechanism of their transformation and concentration in the town, at least it can be interpreted in different ways. We can imagine the small mountain town as an island of paradise for the older people in the region, which, in addition to saving them from loneliness and abandonment, provides a livelihood for many care workers and contributes to the well-being of the municipality and the local community. At the same time, it is no less justifiable to see it as a huge institution that capitalises on old age and, however much it may seem like a cozy home, carries the danger – of following the “mainstream” in the national social policy (in 2019) and as evident during the COVID-19 pandemic – of condemning its residents to insecurity and isolation. In any case, the example of Dryanovo stands for a dynamic “landscape of care” or what Christine Milligan discussed as “care restructuring within localised contexts” triggered by “political, economic and historical factors that vary both between local authority areas and within them.”[2]
With the end of state socialism, the public/social care for older people in Dryanovo changed its conception, scale, and agency. It now followed and relied on EU models and funding, it was relocated from the rural periphery to the centre of the town; while the services were concentrated in the town, their management and administration was delegated from the state to the municipality and NGOs according to the policy of centralisation, implemented in the first decade of the democratisation process in Bulgaria (Society for Social Assistance in Dryanovos case). This change however does not seem to be the final one. The care set-up continues to be a space where the socialist and post-socialist legacies intersect. The founders of the Society successfully transferred their socialist expertise in the social sphere to the work on EU programmes, and Covid-19 returned the users of the day care centre and the home for people with dementia to the period of closed institutions. Hence, the case of Dryanovo can equally be considered as a sustainable and unsustainable development of specific care sources, combining beautiful nature and long-term experience in provision of care for older people with an inconsistent and complicated local application of EU social policies towards ageing.
Bibliography
[1] In general, the term “older people” or “older adults” is used in this article. Unless otherwise stated, “elderly” is only used here when referring to an official English-language translation of Bulgarian documents.
[2] Christine Milligan: Geographies of Care. Space, Place and the Voluntary Sector. Routledge, 2017: New York and London, p. 3.
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